9605 EVERGREEN WAY PACIFIC MARKET 2023-06-20

ECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits PROD •T SITE INFQRMATlON z r a, PROJECT ADDRESS: 9605 EVERGREEN WAY, EVERETT 98208 BUILDING AREA: 500 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL CTRIC L PP !, "I ORNI ITI N &`DE TION OF WORK CONTRACT PRICE OF WORK:$ 500.00 ASSOCIATED BUILDING PERMIT#(if applicable): > /ADO DESCRIBE SCOPE OF WORK: Replace one faulty fire alarm panel with new like for like fire alarm panel THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ Security System ✓❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑ Other(List All) �rtsit.'�'. .... - - r. ■�■1 ,. ki.. - ll'.'.y# ¢cct'.t a'Jt..!1.� ' r L'1� t�,�r7i'trr'� "i` a nl�!ww� i'* . 'ix ' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: I� NO YES--See Below&Pg.2 ✓ By checking this box, I am stating that I have read and understand all of WAC 296-46B-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. r� ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓❑NO EYES-See Below&Pg. 3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. 4A'yY}�iCONTA T INFORMATION �� itr ''' OWNER NAME: WILLIAM HANNAN TENANT BUSINESS NAME(If Commercial): PACIFIC MARKET BUILDING OWNER MAILING ADDRESS: STREET PO BOX 92 c,T,, MINERAL STATE WA ZIF 98355 OWNER PHONE:912 596 6527 OWNER EMAIL: ,,,..,,R .,.. tv.,.-...,.;.,...=. 1.,.,...,,;.,,-x•, ,.,-,.r,_.,�;a...,� ,ter,., ,.�.u... ,... ..,.,rz„ .. ,., . .,4::, .�..�.... ,_ .... .rs,�,,. _. „,.a.. �,.. ., <r�^ CONTRACTOR NAME: FIRE PROTECTION INC CONTRACTOR ADDRESS: STREET 17410 ASH WAY, Ste 8 cmi' LYNNWOOD STATE WA zin 98037 CONTRACTOR PHONE:425 290 9600 CONTRACTOR EMAIL:MEGAN@FPISEATTLE.COM CONTRACTOR LIC.#(REQUIRED):FIREPI*021 ML ,CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 038814 PRIMARY CONTACT: Ell OWNER ❑✓CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 290 9600 MEGAN VAUGHN CONTACT EMAIL:MEGAN@FPISEATTLE.COM AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 1 Owner A horized gent Si nature Date (Revised 1/11/2019) Page 1-Application